Pediatrics Chapter 6

A mother calls the advance practice pediatric nurse practitioner about her 7-year-old daughter's dental hygiene. The daughter has had three cavities. She does not know what to do and asks the nurse for guidance. How should the nurse respond?

"Are you able to supervise her brushing?"

During a routine wellness examination, the nurse is trying to determine how well a 5-year-old boy communicates and comprehends instructions. Which of the following is the best specific trigger question to determine the preschooler's linguistic and cognitive progress?

"How well does your son communicate or follow instructions?"

The nurse is discussing the topic of obesity with a group of mothers of school-age children. Which of the following statements made by the caregivers indicates the best understanding of factors that contribute to obesity?

"I always cook foods that are low in fat."

The nurse is discussing nutrition with the mother of a 6-year-old boy. Which of the following responses by the boy's mother indicates a need for further discussion?

"I make him eat some of everything I put on his plate."

The nurse is caring for a 6-year-old boy. During the course of a routine wellness examination, the mother proudly reports that the child eats whatever the mother puts on his plate. The nurse wants to emphasize the importance of allowing the child to make some of his own choices regarding the types of foods he eats. How should the nurse communicate this to the mother?

"Now is the time to let him choose some of his meals."

The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond?

"Remind her in simple terms what will happen in the dentist's office."

The mother of a 6-year-old girl calls the nurse because her daughter has developed a fear of loud alarms and sirens, and she was recently frightened by her school's fire drill. The mother asks for guidance. How should the nurse respond?

"Try desensitization with an alarm clock or stove buzzer."

The nurse is conducting a required wellness examination for a 5-year-old girl who is starting kindergarten in a few months. Her mother confides that she thinks her daughter, who is the baby of the family, is not quite ready for kindergarten. How should the nurse respond?

"What worries you the most about her readiness?"

A parent brings a 6 year old to the clinic and informs the nurse that the child is tired all the time even though the child sleeps 7 to 8 hours each night. What is the best response by the nurse?

"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."

The parents of a 7-year-old girl report concerns about her seemingly low self-esteem. The parents question how self-esteem is developed in a young girl. Which response by the nurse is best?

"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."

The nurse is assessing the nutritional needs of an 8-year-old girl who weighs 65 pounds. Which of the following amounts would provide the proper daily caloric intake for this child?

2,065 calories per day The girl would need approximately 2,065 calories per day. (29.5 kg x 70 calories per day per kg = 2,065 calories per day).

A nurse is caring for a hospitalized 7 year old whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group?

A paint-by-numbers activity

A nurse is assigned to care for a 7 year old with cystic fibrosis. The child wants to show the nurse his collection of baseball cards. The nurse understands that the collection of objects is common in this age group and is known as what type of thinking?

Classification

The school-age child develops the ability to recognize that if a block of clay is in a round ball and then is flattened, the shape changes but not the amount of clay. This child has developed an understanding of which of the following?

Conservation

The nurse is about to see a 9-year-old girl for a well child check-up. Knowing that the child is in Piaget's period of concrete operational thought, which characteristic should the child display?

Consider an action and its consequences

A nurse is carrying on a conversation with a 7-year-old girl during an office visit. Which of the following is an example of the level of language development the nurse should expect in this child?

Difficulty understanding the concept of "half past" in reference to time

The nurse is educating the parents of a 6-year-old boy how to manage the child's introduction into elementary school. The child has an easy temperament. Which should the nurse suggest?

Helping the child deal with minor stresses The child with an easy temperament will adapt to school with only minor stresses. The slow-to-warm child will experience frustration. The difficult child will be moody and irritable and may benefit from a preschool visit

Eight-year-old Matt is doing well with adding and subtraction. His father asks for suggestions regarding projects that would help increase Matt's understanding of conservation of mass. Of the following projects, which would most help Matt understand conservation of mass?

Form vases from blocks of clay.

A 9-year-old boy has arrived for a health maintenance visit. Which milestone of physical growth should the nurse expect to observe?

Lymphatic tissue growth is complete providing greater resistance to infections.

A mother brings her 8-year-old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that the mother is concerned that there is something wrong. The girl has no other symptoms, however. The nurse knows that which of the following is most likely the cause of the enlarged tonsils?

Normal growth of lymphatic tissue for this age

Which of the following best describes Erikson's psychosocial development task for the school-age child?

The child wants to successfully complete activities.

A nurse will talk with two 10-year-old fraternal twin boys who are concerned about their physical differences. What concept should guide the nurse initially?

There are many differences between fraternal twins including growth rates.

On physical examination, you discover that a 6-year-old's palatine tonsils are somewhat enlarged in the back of his throat. Your best action would be to

record this as a normal early school-aged finding.